Membership

October 2010

Dear Colleagues:Annoucement for IASLC Fellowship Award, Young Investigators Award and Prevent Cancer Foundation Award – see below. The announcement is translated to Chinese and Japanese and will be e-mailed to the respective members. Maybe please ask the Chinese and Japanese members to be mentors for fellows and help with the application. Deadline, January 2010.IASLC receive a lot of recommendations from members for new IASLC Board of DirectorsElectronic payment via website www.iaslc.org – PayPal – new invoices for 2011 will be e-mailed soon.The IASLC Office had hired 2 new employee – Director of Memberships and Director of Communications who both will start November 15, 2010.Fred R. Hirsch, MD, PhDEditor

Lung cancer screening trial results show mortality benefit with low-dose CT:Twenty percent fewer lung cancer deaths seen among those who were screened with low-dose spiral CT than with chest X-ray The National Cancer Institute (NCI) is today releasing initial results from a large-scale test of screening methods to reduce deaths from lung cancer by detecting cancers at relatively early stages.The National Lung Screening Trial (NLST), a randomized national trial involving more than 53,000 current and former heavy smokers ages 55 to 74, compared the effects of two screening procedures for lung cancer -- low-dose helical computed tomography (CT) and standard chest X-ray -- on lung cancer mortality and found 20 percent fewer lung cancer deaths among trial participants screened with low-dose helical CT. The NLST was sponsored by NCI, a part of the National Institutes of Health, and conducted by the American College of Radiology Imaging Network (ACRIN) and the Lung Screening Study group. A paper describing the design and protocol of the NLST, “The National Lung Screening Trial: Overview and Study Design” by the NLST research team, was published yesterday by the journal Radiology and is openly available at http://radiology.rsna.org/cgi/content/abstract/radiol.10091808.“This large and well-designed study used rigorous scientific methods to test ways to prevent death from lung cancer by screening patients at especially high risk,” said Harold Varmus, M.D., NCI Director. “Lung cancer is the leading cause of cancer mortality in the U.S. and throughout the world, so a validated approach that can reduce lung cancer mortality by even 20 percent has the potential to spare very significant numbers of people from the ravages of this disease. But these findings should in no way distract us from continued efforts to curtail the use of tobacco, which will remain the major causative factor for lung cancer and several other diseases.”The NCI’s decision to announce the initial findings from the NLST was made after the trial’s independent Data and Safety Monitoring Board (DSMB) notified the NCI director that the accumulated data now provide a statistically convincing answer to the study’s primary question and that the trial should therefore be stopped. A fuller analysis, withmore detailed results, will be prepared for publication in a peer-reviewed journal within the next few months. Participants in the NLST are being notified individually of the findings by the study’s investigators. The participant notification letter, as well as the DSMB letter, can be viewed at http://www.cancer.gov/clinicaltrials/noteworthy-trials/nlst.Starting in August 2002, the NLST enrolled about 53,500 men and women at 33 trial sites nationwide over a 20 month period. Participants were required to have a smoking history of at least 30 pack-years and were either current or former smokers without signs, symptoms, or history of lung cancer. Pack-years are calculated by multiplying the average number of packs of cigarettes smoked per day by the number of years a person has smoked.Participants were randomly assigned to receive three annual screens with either low-dose helical CT (often referred to as spiral CT) or standard chest X-ray. Helical CT uses X-rays to obtain a multiple-image scan of the entire chest during a 7 to 15 second breath-hold. A standard chest X-ray requires only a sub-second breath-hold but produces a single image of the whole chest in which anatomic structures overlie one another. Previous efforts to demonstrate that standard chest X-ray examinations can reduce lung cancer mortality have been unsuccessful.The trial participants received their screening tests at enrollment and at the end of their first and second years on the trial. The participants were then followed for up to another five years; all deaths were documented, with special attention given to the verification of lung cancer as a cause of death. At the time the DSMB held its final meeting on October 20, 2010, a total of 354 deaths from lung cancer had occurred among participants in the CT arm of the study, whereas a significantly larger 442 lung cancer deaths had occurred among those in the chest X-ray group. The DSMB concluded that this 20.3 percent reduction in lung cancer mortality met the standard for statistical significance and recommended ending the study.“This is the first time that we have seen clear evidence of a significant reduction in lung cancer mortality with a screening test in a randomized controlled trial. The fact that low-dose helical CT provides a decided benefit is a result that will have implications for the screening and management of lung cancer for many years to come,” said Christine Berg, M.D., NLST project officer for the Lung Screening Study at NCI.An ancillary finding, which was not the main endpoint of the trial’s design, showed that all-cause mortality (deaths due to any factor, including lung cancer) was 7 percent lower in those screened with low-dose helical CT than in those screened with chest X-ray. Approximately 25 percent of deaths in the NLST were due to lung cancer, while other deaths were due to factors such as cardiovascular disease. Further analysis will be required to understand this aspect of the findings more fully.The NCI and its partners conducted this trial to obtain the most reliable results possible about the potential benefits of lung cancer screening. Others will begin to use the extensive data from this trial to conduct further analyses and to propose clinical guidelines and policy recommendations for lung cancer screening.“The results of this trial provide objective evidence of the benefits of low-dose helical CT screening in an older, high-risk population and suggest that if low-dose helical CT screening is implemented responsibly, and individuals with abnormalities are judiciously followed, we have the potential to save thousands of lives,” said Denise Aberle, M.D., NLST national principal investigator for ACRIN. “However, given the high association between lung cancer and cigarette smoking, the trial investigators re-emphasize that the single best way to prevent lung cancer deaths is to never start smoking, and if already smoking, to quit permanently.”The possible disadvantages of helical CT include the cumulative effects of radiation from multiple CT scans; surgical and medical complications in patients who prove not to have lung cancer but who need additional testing to make that determination; and risks from additional diagnostic work-up for findings unrelated to potential lung cancer, such asliver or kidney disease. In addition, the screening process itself can generate suspicious findings that turn out not to be cancer in the vast majority of cases, producing significant anxiety and expense. These problems must, of course, be weighed against the advantage of a significant reduction in lung cancer mortality.It should also be noted that the population enrolled in this study, while ethnically representative of the high-risk U.S. population of smokers, was a highly motivated and primarily urban group that was screened at major medical centers. Thus the results may not accurately predict the effects of recommending low-dose helical CT scanning for other populations.###Copies of the DSMB and NLST participant letters can be found on the NLST site at http://www.cancer.gov/clinicaltrials/noteworthy-trials/nlst.For a Q&A on the NLST, please go to http://www.cancer.gov/newscenter/qa/2002/nlstqaQA.For a Fact Sheet on the NLST, please go to http://www.cancer.gov/newscenter/pressreleases/NLSTFastFacts.For more information on lung cancer and screening, please go to http://www.cancer.gov/cancertopics/types/lung.“The National Lung Screening Trial: Overview and Study Design" has been published by Radiology. This paper is openly available at http://radiology.rsna.org/cgi/content/abstract/radiol.10091808.NCI leads the National Cancer Program and the NIH effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI Web site at http://www.cancer.gov or call NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

ANNOUNCEMENTIASLC Lung Cancer Fellowship Award2 years duration

IASLC/PCF Prevent Cancer Foundation Fellowship Award2 years durationThe IASLC is proud to announce the annual IASLC Fellowship and Young Investigators Programs.Overall, there are 3 or more awards for two years each and at least one applicant from each region (North America, Europe and Rest of the World) will be funded. There are awards in prevention and translational lung cancer research that are jointly sponsored with the Prevent Cancer Foundation, (PCF), through educational grants from Eli Lilly. There are unrestricted awards in any field of lung cancer research supported by educational grants from Amgen, Genentech, OSI, Eli Lilly, the IASLC and other sponsors.This year at least 3 new unrestricted awards of $40,000 each year for 2 years are available for competition.We are now requesting application for these Fellowships and Young Investigator awards to be awarded in 2011 - 2012. The goal is to reward scientific excellence and to encourage innovative investigations in the field of lung cancer prevention research and translational research with a potential impact on the management of lung cancer. The applications will be evaluated by a Scientific Review Panel; the deadline for submission of the application is January 10, 2011. A decision on applications will be reached by March 2010.Application forms can be found at the website: www.iaslc.orgPlease e-mail you application to: pia.Hirsch@ucdenver.edu latest January 10, 2011.

IASLC Staging Manual:

The IASLC Staging Manual and Handbook in Thoracic Oncologic has now surpassed 35,000 copies sold worldwide. In addition, the Staging Posters and Reference Cards continue to be popular reference aids of the 7th edition staging system for practitioners and tumor boards. IASLC members can continue to order these publications and products at special member pricing (www.iaslcpubs.org; contact info@iaslc-staging.org for further information).

In addition, translations of these publications have been completed or are in process in multiple languages: Chinese, Italian, Japanese, Polish, and Turkish. Discussions about future translations in Spanish, Arabic, and Russian are ongoing.

The new IASLC Staging Manual has been published in different formats. Several years of work from the IASLC Staging Committee and particularly the chair Dr. Peter Goldstraw, has resulted in a formal staging manual. The book and the “pocket-cards” can be ordered at www.iaslc.org

JTO Mobile options

JTO is available for your iPhone, Blackberry, or Android phone, in a view designed for easy reading on a small screen. Type jto.org into your phone’s browser to access the site. You can view current issue table of contents, most viewed articles, most emailed articles, or search across issues. If you have created a user name and password on the desktop version of JTO.org, you can use that same log in information to view full text articles, complete with illustrations.

IASLC Textbook – Editor in Chief: Harvey I. Pass, MD

Lung Cancer Book from Lippincott: The Fourth Edition of Principles and Practice of Lung Cancer, edited by Harvey I. Pass, MD et al is now available. For more information about the 1040 page book, with 330 illustrations (ISBN-10:0-7817-7365-2) or www.lww.com/product/?978-0-7817-7365-2.

Names:

James R Jett MD has joined the faculty of National Jewish Health, Department of Medicine and section of Oncology, in Denver, Colorado. He is joining Dr Jeffrey Kern, Chief of Oncology, who started the program in 2009. Dr Jett is Professor of Medicine with responsibilities in both patient care and clinical and translational research, with an emphasis on screening and early detection of lung cancer. " I am delighted about this wonderful opportunity to work with the outstanding scientists and clinicians at National Jewish Health and the University of Colorado. This is an opportunity of a lifetime." Dr Jett will continue his responsibilities as Editor-in-Chief of the Journal of Thoracic Oncology